贝氏蛔虫病(浣熊蛔虫感染)在两个无亲缘关系的儿童-洛杉矶县,加利福尼亚州,2024。

Aisling M Vaughan,Dina Kamel,Michelle Chang,Laura Saucier,Susan P Montgomery,Elizabeth Wendt,Alicia H Chang,Shamim Islam,Aaron Nagiel,Betty Situ,Jamie Middleton,Dawn Terashita,Sharon Balter,Joy E Gibson,Jemma Alarcón
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摘要

浣熊蛔虫(Baylisascaris procyonis)是一种常见于浣熊的寄生虫,当它侵入内脏器官或眼部和中枢神经系统时,可引起人类严重疾病。若不及时治疗,原生殖道芽胞杆菌感染可导致严重并发症和死亡。在2024年9月,洛杉矶县公共卫生部门接到了两名与贝氏蛔虫病无关的儿科患者的通知,他们的神经系统体征和症状与贝氏蛔虫病一致,包括行为改变、嗜睡和步态不稳定。第一个病例发生在一名14岁的青少年,他之前被诊断为自闭症谱系障碍,并有异食癖史(即摄入非食物物品);第二个病例发生在一名以前健康的15个月儿童中。两人均用阿苯达唑和皮质类固醇治疗。第一位患者恢复到基线神经系统状态,但第二位患者的诊断和治疗延误导致严重的神经系统后遗症。流行病学调查发现,从屋顶厕所(即公共的浣熊排便场所)落下的浣熊粪便可能是该青少年的接触源。没有确定年幼儿童的接触源。对于有神经系统症状和脑脊液或外周血嗜酸性粒细胞增多(嗜酸性粒细胞/mL血)的患者,特别是幼儿或发育障碍者或异食癖者,应怀疑原生殖道芽胞杆菌感染并考虑及时治疗。此外,公众应了解接触预防策略,包括防止浣熊在房屋周围活动,避免接触浣熊粪便,并安全清除浣熊厕所。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Baylisascariasis (Raccoon Roundworm Infection) in Two Unrelated Children - Los Angeles County, California, 2024.
Baylisascaris procyonis (raccoon roundworm), a parasite commonly found in raccoons (Procyon lotor), can cause severe disease in humans when it invades visceral organs or the ocular and central nervous systems. Without prompt treatment, B. procyonis infection can lead to serious complications and death. During September 2024, the Los Angeles County Department of Public Health was notified of two unrelated pediatric patients with neurologic signs and symptoms consistent with baylisascariasis, including behavioral change, lethargy, and gait instability. The first case occurred in an adolescent aged 14 years who had received a previous diagnosis of autism spectrum disorder and had a history of pica (i.e., ingestion of nonfood items); the second case occurred in a previously healthy child aged 15 months. Both were treated with albendazole and corticosteroids. The first patient returned to baseline neurologic status, but delays in diagnosis and treatment of the second patient resulted in severe neurologic sequelae. Epidemiologic investigations identified raccoon feces that had fallen from a rooftop latrine (i.e., a communal raccoon defecation site) as the possible source of exposure for the adolescent. No source of exposure was identified for the younger child. B. procyonis infection should be suspected and prompt treatment considered in patients with neurologic symptoms and cerebrospinal fluid or peripheral blood eosinophilia (>1,000 eosinophils/mL of blood), especially young children or persons with developmental disabilities or pica. In addition, the public should be aware of exposure prevention strategies, including preventing raccoon activity around properties, avoiding exposure to raccoon feces, and safely removing raccoon latrines.
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